改良腹直肌旁入路与改良Stoppa入路治疗髋臼骨折临床疗效比较

杨华, 向磊, 蒋红兵, 胡兵兵, 曾参军, 张彬, 刘伟

中国临床解剖学杂志 ›› 2023, Vol. 41 ›› Issue (5) : 603-607.

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中国临床解剖学杂志 ›› 2023, Vol. 41 ›› Issue (5) : 603-607. DOI: 10.13418/j.issn.1001-165x.2023.5.18
临床研究

改良腹直肌旁入路与改良Stoppa入路治疗髋臼骨折临床疗效比较

  • 杨华1,    向磊1,    蒋红兵1,    胡兵兵1,    曾参军2,    张彬1,    刘伟1*
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Comparison of clinical efficacy of modified Stoppa approach and modified pararecutus abdominis approach in the treatment of acetabulum fractures

  • Yang Hua1, Xiang Lei1, Jiang Hongbing1, Hu Bingbing1, Zeng Canjun2, Zhang Bin1, Liu Wei1*
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摘要

 目的    探讨改良腹直肌旁入路与改良Stoppa入路手术治疗髋臼骨折的临床疗效差异。  方法    回顾2020年1月至2022年1月我院完成的22例髋臼骨折手术,其中改良腹直肌旁入路13例(实验组),改良Stoppa入路9例(对照组),比较两组性别、年龄、受伤至手术时间、骨折分型、手术时间、术中出血量、术后Matta评分及髋关节功能评分。  结果    两组患者术前一般资料无统计学差异(P>0.05),具有可比性;骨折复位优良率及髋关节功能优良率无统计学差异(P>0.05)。实验组手术时间(124.54±52.21)min,术中出血量(318.46±65.68)mL,均优于对照组(175.00±59.28)min,(403.33±98.62)mL,P<0.05。  结论    相较于改良Stoppa入路,采用改良腹直肌旁入路手术治疗髋臼骨折可减少手术时间及出血量。

Abstract

Objective   To investigate the clinical effect of the modified Stoppa approach and modified pararecutus abdominis approach in the treatment of acetabular fractures.    Methods    A retrospective study was performed to analyze the clinical data of 22 operated patients with acetabular fractures in our hospital from January 2020 to January 2022. Among them, 13 cases were operated with the modified pararecutus abdominis approach (experimental group) and 9 cases were operated with the modified Stoppa surgical approach (control group). The gender, age, time from injury to operation, fracture typing, operation time, blood loss during operation, postoperative Matta score and hip function score were recorded and compared between the two groups.   Results   The general preoperative data of the two groups were not statistically significant (P>0.05) and were comparable. There was no significant difference in the rate of excellent quality of fracture reduction and the rate of excellent hip function between the two groups (P>0.05). In the control group, the operative time was (175.00±59.28) min, and the intraoperative blood loss was (403.33±98.62) ml. The operative time of the experimental group was (124.54±52.21) min and the intraoperative bleeding was (318.46±65.68) ml, both were better than those of the control group (P<0.05).   Conclusions   Compared with the modified Stoppa surgical approach, surgical treatment of acetabular fractures with the modified pararecutus abdominis approach reduces operative blood loss and operative time . It is a reliable treatment for pelvic acetabular fractures through the anterior approach.

关键词

髋臼 /  骨折 /  骨折内固定 /  改良腹直肌旁入路

Key words

 Acetabulum;  /   / Fracture;  /  Fracture internal fixation;  /  Modified pararecutus abdominis approach

引用本文

导出引用
杨华, 向磊, 蒋红兵, 胡兵兵, 曾参军, 张彬, 刘伟. 改良腹直肌旁入路与改良Stoppa入路治疗髋臼骨折临床疗效比较[J]. 中国临床解剖学杂志. 2023, 41(5): 603-607 https://doi.org/10.13418/j.issn.1001-165x.2023.5.18
Yang Hua, Xiang Lei, Jiang Hongbing, Hu Bingbing, Zeng Canjun, Zhang Bin, Liu Wei. Comparison of clinical efficacy of modified Stoppa approach and modified pararecutus abdominis approach in the treatment of acetabulum fractures[J]. Chinese Journal of Clinical Anatomy. 2023, 41(5): 603-607 https://doi.org/10.13418/j.issn.1001-165x.2023.5.18
中图分类号: R682.4    

参考文献

[1]  Srivastava A, Rajnish RK, Kumar P, et al. Ilioinguinal versus modified Stoppa approach for open reduction and internal fixation of displaced acetabular fractures: a systematic review and meta-analysis of 717 patients across ten studies[J]. Arch Orthop Trauma Surg, 2023, 143(2): 895-907. DOI: 10.1007/s00402-022-04369-6.
[2]  Cosgrove CT, Berkes MB, McAndrew CM, et al. Kocher-langenbeck approach for posterior wall acetabular fractures[J]. J Orthop Trauma, 2020, 34 Suppl 2: S21-S22. DOI: 10.1097/BOT.0000000000001816.
[3]  Tosounidis TH, Giannoudis VP, Kanakaris NK, et al. The ilioinguinal approach: state of the art[J]. JBJS Essent Surg Tech, 2018, 8(2): e19. DOI: 10.2106/JBJS.ST.16.00101.
[4]  张华明, 王福琴, 陈劲, 等. 腹直肌旁入路与改良Stoppa入路治疗髋臼骨折的疗效分析[J]. 广东医科大学学报, 2017, 35(5): 525-527. DOI: 10.3969/j.issn.1005-4057.2017.05.019.
[5] Singh SV, Chopra RK, Puri G, et al. Clinico-radiological evaluation of modified stoppa approach in treatment of acetabulum fractures[J]. Cureus, 2020, 12(9): e10193. DOI: 10.7759/cureus.10193.
[6] Kacra BK, Arazi M, Cicekcibasi AE, et al. Modified medial Stoppa approach for acetabular fractures: an anatomic study[J]. J Trauma, 2011, 71(5): 1340-1344. DOI: 10.1097/TA.0b013e3182092e8b.
[7] Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach: a 10-year perspective[J]. J Orthop Trauma, 2006, 20(1 Suppl): S20-S29. DOI: 10.1097/,00003086-199408000-00003.
[8] Soni A, Gupta R, Sen R. Modified stoppa approach for acetabulum fracture: a review[J]. Rev Bras Ortop (Sao Paulo), 2019, 54(2): 109-117. DOI: 10.1016/j.rboe.2017.09.006.
[9] Hirvensalo E, Lindahl J, Bostman O. A new approach to the internal fixation of unstable pelvic fractures[J]. Clin Orthop Relat Res, 1993, (297): 28-32. DOI: 10.1097/00003086-199312000-00007.
[10]Archdeacon MT, Kazemi N, Guyp P, et al. The modified Stoppa approach for acetabular fracture[J]. J Am Acad Orthop Surg, 2011, 19(3): 170-175. DOI: 10.12671/jkfs.2014.27.4.274.
[11]Keel MJB, Ecker TM, Cullmann JL, et al. The Pararectus approach for anterior intrapelvic management of acetabular fractures: an anatomical study and clinical evaluation[J]. J Bone Joint Surg Br, 2012, 94(3): 405-411. DOI: 10.1302/0301-620X.94B3.27801.
[12]林羲疆, 李严兵, 黄华军, 等. 改良腹直肌旁切口入路前路钢板固定骶骨骨折的解剖学研究[J]. 中华创伤骨科杂志, 2021, 23(11): 969-974. DOI: 10.3760/cma.j.cn115530-20210111-00013.
[13]黄复铭, 樊仕才, 黄海舟, 等. 基于髋臼骨折三柱分型的手术入路选择策略[J]. 中国临床解剖学杂志, 2021, 39(6): 750-754. DOI: 10.13418/j.issn.1001-165x.2021.06.024.
[14]Pohlemann T, Herath SC, Braun BJ, et al. Anterior approaches to the acetabulum: which one to choose[J]?. EFORT Open Rev, 2020, 5(10): 707-712. DOI: 10.1302/2058-5241.5.190061.
[15]Elmadag M, Guzel Y, Aksoy Y, et al. Surgical treatment of displaced acetabular fractures using a modified stoppa approach[J]. Orthopedics, 2016, 39(2): e340-345. DOI: 10.3928/01477447-20160222-07.
[16]Bastian JD, Tannast M, Siebenrock KA, et al. Mid-term results in relation to age and analysis of predictive factors after fixation of acetabular fractures using the modified Stoppa approach[J]. Injury, 2013, 44(12): 1793-1798. DOI: 10.1016/j.injury.2013.08.009.
[17]张潇, 熊然, 李涛, 等. 经腹直肌外侧切口入路治疗髋臼骨折的解剖学研究[J]. 中国临床解剖学杂志, 2015, 33(1): 17-20. DOI: 10.13418/j.issn.1001-165x.2015.01.005.
[18]Bastian JD, Savic M, Cullmann JL, et al. Surgical exposures and options for instrumentation in acetabular fracture fixation: Pararectus approach versus the modified Stoppa[J]. Injury, 2016, 47(3): 695-701. DOI: 10.1016/j.injury.2016.01.025.
[19]李绍良, 苏永刚, 王满宜. 单独应用改良Stoppa入路或结合髂窝入路治疗髋臼骨折的近期疗效分析[J]. 中华创伤骨科杂志, 2022, 24(3): 219-224. DOI: 10.3760/cma.j.cn115530-20211129-00541.
[20]Sagi HC, Afsari A, Dziadosz D. The anterior intra-pelvic (modified rives-stoppa) approach for fixation of acetabular fractures[J]. J Orthop Trauma, 2010, 24(5): 263-270. DOI: 10.1097/BOT.0b013e3181dd0b84.

基金

湖南省自然科学基金面上项目(2022JJ30546);湖南省科学技术厅临床医疗技术创新引导项目(2020SK51902);南华大学2022年研究生科研创新项目(223YXC034);南华大学医院管理研究与改革项目(2021YYGL09);湖南省学位与研究生教育改革研究项目(2021JGYB148)

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